(Sep. 28, 2008) The Yomiuri Shimbun
Unclear what Masuzoe means by 'drastic review'
後期高齢者医療 意味不明な「抜本的見直し」(9月28日付・読売社説)

The government and ruling parties have been blowing hot and cold over the new medical insurance system for those aged 75 and older.

Health, Labor and Welfare Minister Yoichi Masuzoe proposed a drastic review of the system, and Prime Minister Taro Aso backed the idea. However, it is not clear what such a "review" would mean in effect, and some lawmakers even within the ruling parties oppose the move.

The Liberal Democratic Party and New Komeito referred to the system in their latest agreement to maintain the coalition government, saying they would try to improve the system by taking into consideration elderly people's feelings about it.

It goes without saying that governments should strive to improve every policy and system. But this is different from drastically reviewing them.


Proposal ill thought out

Masuzoe said his proposal focuses on three principles: not distinguishing those insured only by their age; changing the current system of mandatorily deducting insurance premium payments from participants' pension accounts to a voluntary system; and ensuring that any changes to be made do not exacerbate feelings of inequity between working people and retirees receiving insurance premium payments.

The first point may be the most important. The current system was intended to create a united medical insurance system for those aged 75 and older, whose medical fees have increased steeply in recent years, and to support aged people equally, notwithstanding the fact that working generations subscribe to various corporate health insurance plans.

If the government and ruling parties decide to do away with the new system's age-bracket provisions because they worry overly that elderly people aged 75 and older have loudly protested against being described as koki koreisha (late-stage elderly people)--as the system refers to them--they will have to rebuild the system from scratch.

If those who continue to work regardless of their age are allowed to subscribe to corporate health insurance plans as members of the working generations, the government and ruling parties will merely have broadened the options of such people. This does not go beyond the framework of system improvement.

It is difficult to describe the first of the three points of Masuzoe's proposal--not distinguishing between those insured in regard to their age bracket--as a "drastic review" because an "improvement" is not the same as a "drastic review."


Alternative plan needed

The third point--aiming at a system that will not worsen feelings of inequity between working people and retirees--also is unclear. After all, the health insurance system for elderly people that lasted until fiscal 2007 hit a wall due to ambiguous rules on sharing burdens between working people and retirees.

Masuzoe said he intends to ask an expert panel to discuss the makeup of an ideal new system from square one. But there are too many ambiguous points of contention.

In a Yomiuri Shimbun poll held immediately after the launch of the Aso Cabinet, 67.5 percent of respondents said they highly evaluated the agreement between the LDP and New Komeito to review the new medical insurance system for those aged 75 and older. This figure reflects people's dissatisfaction with the current situation.

But merely parroting the vague slogan "review" without offering a clear future vision can only be seen as a vote-catching gambit ahead of the forthcoming general election. Under the current situation, the government and ruling parties are in no position to criticize the opposition parties, which have demanded the abolition of the current system without putting forward an alternative plan.

A long-range outlook is needed for reform of the social security system, including medical care for elderly people. If the government and ruling parties run about in confusion every time an election approaches, public anxiety and dissatisfaction will accumulate.

(From The Yomiuri Shimbun, Sept. 28, 2008)
(2008年9月28日01時42分 読売新聞)

by kiyoshimat | 2008-09-28 08:14 | 英字新聞

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